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Background In view of the expected increase in expenditure on hip replacement treatment in Belgium [10], the complication rate [3] and the possible reduction in waste estimated by the OECD [1], we are not yet in a position to objectify the effectiveness of hip replacement treatment in Belgian hospitals. This objective study aims to propose a hospital comparison through the use of a cost-DALY ratio for hip replacement surgery among 12 Belgian hospitals. Methods In our study, the DALY calculation was applied at the hospital level for complications. Mortality was calculated on the basis of the Belgian mortality and life expectancy tables [15]. A DALY has been assigned to readmissions within 30 days. The costs of this study are the hospital costs of the PACHA hospital analysis. The adjusted values (costs and DALYs) were obtained by relating the observed value to the predicted value obtained from the linear regression model. Results We have 2,411 inpatients with an average age (Standard Deviation) of 69 years (13.5 years). The complication rate during hospital stays is estimated at 6.93% while the mortality rate is 1.20%. The average cost (SD) of a stay is €8,013 (€4,304). We have registered a total of 246.5 DALYs for the 12 hospital institutions in the study. Conclusion Other indicators should complete our study, including the patient's perception of the actual results experienced by the patient. Our analysis invites the authorities to create good practice guides for common diseases such as hip replacement surgery. Based on this first experience for the orthopaedic sector, we are convinced of the usefulness of our approach in evaluating the "cost-effectiveness" of other care systems. |
